Checklist for processing proposal for access permission to Retail outlet at level of NH

Sr. Yes/No Page No

Particulars of documents required Remarks
No (From -To)
( Attached
or Not)
1 Covering Letter. Yes
2 Authority Letter to consultant Yes
3 Processing fee: Trough BHARAT KOSH Online Porttal. Yes

4 Proof of Online Submission of proposal Yes

5 Inspection Report by EE NH.

Duly attested copy of letter of intent (LOI) as issued to the Yes

6 applicant for fuel station/ Retail Outlet.
Duly attested copy of Power of Attorney issued in favour of Yes
7 Authorized signatory.
Original license deeds duly signed by the authorized Yes
8 signatory of FS alongwith two witnesses, duly notarised.

Undertaking from the authorized signatory of FS on Non- Yes

Judicial stamp paper of Rs. 20/- that oil company would pay
the necessary fee for use of national highway land
9 whenever the fee is asked by National Highway Authorities
in future.

Undertaking from the authorized signatory of FS on Non- Yes

Judicial stamp paper of Rs. 20/- that necessary alteration
including complete removal / shifting of the approach road
10 at its own cost if so required by Ministry, for the
development of National Highway or in the interest of
safety of this nation.

Undertaking from the authorized signatory of FS on Non- Yes

Judicial stamp paper of Rs. 20/- that they shall take all the
11 action as prescribed in Appendix-I to ensure conformity to
these norms.

Undertaking from the authorized signatory of FS on Non- Yes

Judicial stamp paper of Rs. 20/- that the fuel station is not
energized nor in operation and that construction of the
12 fuel station has not been commenced.

Checklist with all pages certified from the authorized Yes

signatory of the FS as per Annxure-II of Appendix-I of
13 Ministry's guidelines/ Norms dated 26-June-2020
 Location Plan of fuel station along the National Highways Yes
showing details of the Right of way of National Highway ,
existing, intersections & the intersecting public roads and
other devlopments falling within reach of 1.5 km in each
14 side of private property and carriageway , duly certified by
authorized signatory of FS.

Layout plan of Proposed fuel station showing details of Yes

deceleration , acceleration lanes, service roads ( if
provided) , buffer strip, fuel pump, office, kiosk, lubrication,
air and water supply, toilet and drinking facilities, drainage
15 details, sigh and marking confirming to applicable figures
enclosed with these norms duly certified by authgorized
signatory of FS.

Copy of sectional view of fuel station showing elevation of Yes

fuel station with respect to the national highway and
slopes to be provided for adequate drainage and
16 preventing water logging on National Highway, duly
certified by authorized signatory of FS.

Drainage plan of FS duly certified by authorized signatory Yes

of FS, alongwith hydraulic calculation and comments on
17 adequecy on drainage facility being provided for the same.

Hydraulic calculation certificate. Yes

18
Detail of material for pavement composition for Yes
deceleration lane, service road and acceleration lane duly
19 certified by authorized signatory of FS.

20 Standard condition certificate. Yes

21 Rural/Urban area certificate. Yes

Copy of duly certified latest land record of the proposed Yes

22 location.
Certified copy of Infrastructure Map along with payment
23 receipt for Infrastructure Map.
Documentry evidence of additional land acquisition details Yes Additional
(if required) beyond the available ROW ( to accommodate Land Not
service roads, deceleration/acceleration lanes turning Required.
radius etec.) done by the owner of the fuel station ( Note: it
24 needs to bge specifically mentioned if the same is not
required/applicable).
 Recorded CD / Photographs.
25 AT FRONT